TY - JOUR

T1 - Impact of intensive lifestyle intervention on gut microbiota composition in type 2 diabetes

T2 - a post-hoc analysis of a randomized clinical trial

AU - Wei, Shaodong

AU - Brejnrod, Asker Daniel

AU - Trivedi, Urvish

AU - Mortensen, Martin Steen

AU - Johansen, Mette Yun

AU - Karstoft, Kristian

AU - Vaag, Allan Arthur

AU - Ried-Larsen, Mathias

AU - Sørensen, Søren Johannes

N1 - Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC.

PY - 2022

Y1 - 2022

N2 - Type 2 diabetes (T2D) management is based on combined pharmacological and lifestyle intervention approaches. While their clinical benefits are well studied, less is known about their effects on the gut microbiota. We aimed to investigate if an intensive lifestyle intervention combined with conventional standard care leads to a different gut microbiota composition compared to standard care alone treatment in individuals with T2D, and if gut microbiota is associated with the clinical benefits of the treatments. Ninety-eight individuals with T2D were randomized to either an intensive lifestyle intervention combined with standard care group (N = 64), or standard care alone group (N = 34) for 12 months. All individuals received standardized, blinded, target-driven medical therapy, and individual counseling. The lifestyle intervention group moreover received intensified physical training and dietary plans. Clinical characteristics and fecal samples were collected at baseline, 3-, 6-, 9-, and 12-month follow-up. The gut microbiota was profiled with 16S rRNA gene amplicon sequencing. There were no statistical differences in the change of gut microbiota composition between treatments after 12 months, except minor and transient differences at month 3. The shift in gut microbiota alpha diversity at all time windows did not correlate with the change in clinical characteristics, and the gut microbiota did not mediate the treatment effect on clinical characteristics. The clinical benefits of intensive lifestyle and/or pharmacological interventions in T2D are unlikely to be explained by, or causally related to, changes in the gut microbiota composition.

AB - Type 2 diabetes (T2D) management is based on combined pharmacological and lifestyle intervention approaches. While their clinical benefits are well studied, less is known about their effects on the gut microbiota. We aimed to investigate if an intensive lifestyle intervention combined with conventional standard care leads to a different gut microbiota composition compared to standard care alone treatment in individuals with T2D, and if gut microbiota is associated with the clinical benefits of the treatments. Ninety-eight individuals with T2D were randomized to either an intensive lifestyle intervention combined with standard care group (N = 64), or standard care alone group (N = 34) for 12 months. All individuals received standardized, blinded, target-driven medical therapy, and individual counseling. The lifestyle intervention group moreover received intensified physical training and dietary plans. Clinical characteristics and fecal samples were collected at baseline, 3-, 6-, 9-, and 12-month follow-up. The gut microbiota was profiled with 16S rRNA gene amplicon sequencing. There were no statistical differences in the change of gut microbiota composition between treatments after 12 months, except minor and transient differences at month 3. The shift in gut microbiota alpha diversity at all time windows did not correlate with the change in clinical characteristics, and the gut microbiota did not mediate the treatment effect on clinical characteristics. The clinical benefits of intensive lifestyle and/or pharmacological interventions in T2D are unlikely to be explained by, or causally related to, changes in the gut microbiota composition.

KW - exercise

KW - gut microbiota

KW - lifestyle intervention

KW - metformin

KW - physical activity

KW - standard care

KW - type 2 diabetes

U2 - 10.1080/19490976.2021.2005407

DO - 10.1080/19490976.2021.2005407

M3 - Journal article

C2 - 34965188

AN - SCOPUS:85122098906

VL - 14

JO - Gut Microbes

JF - Gut Microbes

SN - 1949-0976

IS - 1

M1 - 2005407

ER -